Research Topics: Improving Nursing Practice

NURSING PRACTICE

<li class="MsoNormal" style="line-height: 200%"> Define clearly the advanced Practice Nurse.</li> The advanced practice registered nurse is an umbrella term given to a registered nurse (RN) who has met advanced educational and clinical practice requirements beyond the two to four years of basic nursing education required of all RNs. Advanced practice registered nurses includes nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives. Nurse Practitioners may practice independently, or they may work in hospitals, long-term care facilities, and for various health care agencies. Most NPs function primarily as clinicians. NPs may diagnose and treat a wide range of acute and chronic illnesses and injuries, interpret lab results, counsel patients, develop treatment plans, and they may prescribe medication. Clinical Nurse Specialists (CNS), like Nurse Practitioners, practices independently, or works in hospitals, long-term care facilities, and for various health care agencies. CNSs may also function as administrators, researchers, policy-makers, educators, or consultants. Certified Registered Nurse Anesthetist (CRNA) provides anesthetics to patients in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified health care professionals. When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by an anesthesiologist, it is recognized as the practice of medicine. CRNAs practice in every setting in which anesthesia is delivered: traditional hospital surgical suites and obstetrical delivery rooms; critical access hospitals; ambulatory surgical centers; the offices of dentists, podiatrists, ophthalmologists, plastic surgeons, and pain management specialists; and U.S. Military, Public Health Services and Department of Veterans Affairs health care facilities. Certified Nurse Midwives (CNMs) provide primary health care to women. This includes evaluation, assessment, treatment, and referral to a specialist, if required. CNMs provide preconception counseling, care during pregnancy and childbirth, normal gynecological services, and care of the peri- and post-menopausal woman (). Changes in nursing in Hong Kong over the past decade have had more to do with the changes in the world and the region’s economy and population than the changes instituted by the Republic of China. Hong Kong’s nearly 7 million people’s health is, like in other places, threatened by a shortage of skilled and experienced nurses. Hong Kong’s three major university-based nursing programs, if they can work together creatively, have the potential to avert a decline in quality of healthcare in Hong Kong and advance nursing at the same time ( 2006). The first Master of Science nurse practitioner program commenced in 2001 in the Department of Nursing and Health Sciences (now School of Nursing), at the Hong Kong Polytechnic University. Initially, the Yale School of Nursing in the USA was invited and agreed to provide consultative teaching for Master’s students to prepare them to become Adult Health Nurse Practitioners (NP) in Hong Kong. The aim of this program is to offer experienced registered nurses an opportunity to develop the knowledge, understanding and competencies to function effectively as Adult Nurse Practitioners and as nurses leaders in meeting the changing needs of Hong Kong’ s health care system. The initiative to develop an education program for nurse practitioners is supported by the Hospital Authority, which is the largest employer of nurses in Hong Kong. The Hospital Authority has indicated that a Master’s degree with a clinical focus will be requires for promotion, and position of advanced Practice nurse was introduced in 2003 – 2004. it is envisioned that the nurse practitioner’s role would be more visible and a planning group would need to be established to delineate the roles of Nurse practitioners (NP) and to discuss related- regulations in Hong Kong. Nurse clinics have been set – up on hospital and community setting. These clinics now are run by registered nurses with advance academic and clinical experience. The nurse practitioners, with the support of the medical team, focus I n health maintenance, disease prevention, counseling and patient education in a wide variety of setting within different specialties. Nurse Practitioners are professionally accountable for their practice; they also must be given the authority to make decisions in the best interest of patients and within the scope of practice supported by the medical team. The establishment of nurse – clinics in Hospital authority is still at developmental stage. It is understood that important issues such as: legal authority for prescribing, professional liability, regulation of independence practice certification and registration need to be establishes by the Hog Kong Nursing Council ( 2004)             A Code of Professional Conduct for Nurses in Hong Kong was formulated in 1986 by the then Nursing Board of Hong Kong. To keep pace with contemporary health care development commensurate with societal and cultural changes, the Nursing Council of Hong Kong which replaced the Nursing Board of Hong Kong in 1999 has now revised the code and also devised a Code of Ethics for an accurate representation of Nurses’ ethical responsibilities.  The Code of Ethics is adapted largely from the “Code of Ethics for Nurses in the New Millennium” published in a Chinese nursing magazine《中華護理雜誌》with due regard to practices in the international community. Code of Professional Conduct for Nurses in Hong Kong Each nurse (registered or enrolled) is accountable for his/her practice. In the exercise of his/her professional responsibilities, each nurse has an obligation to uphold and adhere to the Code of Professional Conduct for Nurses in Hong Kong.  The code aims to make explicit the standards for professional conduct that nurses shall act at all times in their course of duty.  It may also serve to provide the public with a basis for decisions regarding standards of professional conduct. The Code of Professional Conduct for Nurses in Hong Kong highlights eight aspects of professional conduct that nurses are to comply with in discharging their professional duties. The explanatory statements provide guidelines regarding the way each aspect of professional conduct is to be enacted in practice situations. Eight aspects of professional conduct: In discharging his/her duty in a professional capacity, each nurse shall act, at all times, in such a manner as to: (1) Respect the dignity, uniqueness, values, culture and beliefs of patients/clients and their families in the provision of nursing care. (2) Hold in confidence personal information obtained in a professional capacity. (3) Safeguard informed decision-making and the wellbeing of patients/clients in the provision of care. (4) Provide safe and competent nursing care. (5) Maintain the agreed standard of practice. (6) Foster the trust that is inherent in the privileged relationship between nurses and their patients/clients. (7) Uphold the image of nurses and the profession by refusing advantages. (8) Practice in accordance with laws of Hong Kong relevant to the area of nursing practice. Some Examples of Laws of Hong Kong Related to Nursing Practice are listed in the annex. There are many ordinances which have a direct or indirect application to nursing. The following is a selected list of ordinances related to nursing practice.  It is not intended to be exhaustive: Name of Ordinance Chapter Antibiotics Ordinance 137 Births and Deaths Registration Ordinance 174 Coroners Ordinance 504 Dangerous Drugs Ordinance 134 Defamation Ordinance    21 Hong Kong Bill of Rights Ordinance 383 Hospital Authority Ordinance 113 Hospitals, Nursing Homes and Maternity Homes Registration Ordinance 165 Human Organ Transplant Ordinance 465 Interpretation and General Clauses Ordinance 278 Medical (Therapy, Education and Research) Ordinance 278 Mental Health Ordinance 136 Midwives Registration Ordinance 162 Nurses Registration Ordinance 164 Occupational Safety and Health Ordinance 509 Offences Against the Person Ordinance 212 Personal Data (Privacy) Ordinance 486 Pharmacy and Poisons Ordinance 138 Prevention of Bribery Ordinance 201 Quarantine and Prevention of Disease Ordinance 141   Annex 1: Some Examples of Laws of Hong Kong Related to Nursing Practice Source: The Nursing Council of Hong Kong Code of Professional Conduct and Code of Ethics for Nurses in Hong Kong   The role and function of the regulatory authority in maintaining professional conduct of nurses in Hong Kong they have the Disciplinary Powers that enables them to (1) conduct hearings and investigations to resolve complaints against nurse practitioners for unethical and unprofessional conduct and violations which is stated in Chapter 164, section 17, 18 and 19 under the title of Nurses Registration Ordinance. (2) Issue, suspend, and revoke certificates of registration for the practice of nursing in accordance to the chapter 164, section 24 under the heading of penalties for assumptions of title of nurses, etc. (3) Monitor and enforce quality standards of nursing practice. (4) Employ necessary measures to ensure the maintenance of efficient, ethical and technical, moral and professional standards in the practice of nursing in line with the chapter 164A under the title of nurses (registration and Disciplinary procedure). (5) Make certain quality nursing education setting the guidelines of enrolled nurses that is under the title, enrolled Nurses (Enrolment and Disciplinary Procedure) regulations ( Chapter 4. 2004). (6) Declare Code of Ethics for nurses (, 2002). 2. Future Trend of accountability of Advanced Practice Nurse             Many authors describe the expansion of the role of the nurse to incorporate roles outside that of the traditional acute care setting. Such roles include health promotion and teaching in the community ( 1997). Further, the role of the nurse in community care, especially for the advanced practitioner and the clinical nurse specialist, is also a potential role in the future because new opportunities are being made available for nurses as a result of the expansion of home care , 1997). Such nurses are recognised as having developed a specialist expertise and are utilized as educators and advisers in addition to the role of clinician. Further, an increased involvement in the area of rehabilitation is seen to be increasingly vital to facilitate the earlier release of clients back to their homes. It is argued that the role of the nurse is insufficiently recognised and so not utilized as effectively as may be possible ( 1996).                Greater autonomy is clearly indicated by discussion of the new role of independent nurse practitioners which have been recently identified through a longitudinal study in Australia to be an important new role for the registered nurse ( 1996) This role has been particularly targeted for meeting the needs of rural communities ( 1995) and has been variously described as either working in conjunction with a medical practitioner or perhaps replacing the general practitioner in those more isolated settings in which a doctor is not available. A greater autonomy, particularly when linked to the nurse practitioner, facilitates the provision of a variety of services in, for example, women’s health (, 1996), and so further expand the areas in which nursing is practised. This also involves increased collaboration with the patient (, 1997). The ideal of advocacy is linked to holism and caring which have both gained significant prominence in nursing philosophy over the last decade. There has also been discussion over new responsibilities that are less directly linked to clinical nursing care. One of these new directions is the role of Case Manager ( 1997). Such a role involves autonomy and coordination responsibilities for the care of clients. Increased research activity has also been identified as being increasingly central to the role of the registered nurse (1997). The increased emphasis on evidence-based practice ( ,   1997; 1997) also dictates that nurses must be able to consume and conduct research to ensure that the best possible principles of care are being followed. The role of researcher is one which continues to be highly regarded as a role which can facilitate change within the health care delivery system (, 1997). The implication of research having a more central position in the nurses duties is that nursing knowledge will be more congruent with the clinical setting (, 1997) and so ensuring that practice is always effective. A number of authors also believe that there will be (or should be) a bigger participation of nurses in health policy development ( 1997; , 1997). The arguments revolve around the notions of empowerment for nurses to make decisions regarding resources to ensure that the clients needs can be met. Central to these arguments is a strong commitment to ensuring continued quality of care for a client who aligns with the earlier discussion of holism and advocacy. Considering the future role of the nurse from a global perspective, the World Health organisation released a report in 1994 (, 1994). The report suggested that nurses need to address the health needs of people in vulnerable groups. In addition, the report suggested that nurses should consider their reluctance to work in rural areas as these areas were suffering a shortage of health personnel.             Therefore, one may conclude that accountability of APN is largely greater in the future in meeting the demands of the clients. Since, they integrate into their practice elements such as diagnosing and treating health problems and prescribing drugs. Nurse practitioners work autonomously, from initiating the care process to monitoring health outcomes, and they do work in collaboration with other health care professionals. Nurse practitioners practice in a variety of community, acute care and long term care settings. These include but are not limited to community health centers, nursing outposts, specialty units and clinics, emergency departments and long- term facilities.             In the context of the statement above, an advanced nurse practitioner must be competent enough to practice the nursing profession especially in critical situations and its practice must be evidence – based that is gained in additional clinical practice, education and experience. If one fails to do this, one is not endangering the life of the client or patient, ergo; safe, efficient and effective care wasn’t met.  For an instance, wrong prescription, over dosage or under dosage of medicines that would lead to different result as expected thus, endangering the life of the client and it might even cause death. Prescriptive authority should be within of the license to practice in order to avoid any medication error and proper referrals are given to help achieve the desired pre-illness phase of the patient. It is said that nurses can now work independently as well as collaboration with other health care professionals, this means to say that nurses must not only knowledge and skills equipped at the same time; attitude must be healthy enough that conforms with the different aspects of a person. Accountability could be further enhanced if nurses were more involved in the decision making processes which influenced health care. Accountability was directly linked to the perception of autonomy. It is indicated that there is a desire for increased autonomy and an acknowledgment that this autonomy should be matched with a need for increased knowledge and recognition of this knowledge by others in the health care field.             The Nursing Council in Hong Kong must maintain the ideal status of the nurses with their rules and regulations that not only meet the standards of quality education and quality care; they must be able to expand their horizons to new opportunities by continuous research. Since, the nature of practice that requires advanced knowledge, clinical proficiency, independent decision – making and autonomy. The risk of harm from unsafe and incompetent providers at this level of complex is high. In order for one to be qualified as an advanced nurse practitioner there must be an advanced practice graduate nursing education and professional certification examinations that should meet the established criteria. This will require a commitment to ongoing education and professional development due to the fact that nursing blends with the changing of times so does the health of the people. It is unwise to continue to proliferate subspecialty programs because graduates of these advanced nurse practitioner programs are expected to be licensed and legal recognition of narrow is cope is inappropriate that is why it is important to continue to meet the criteria for licensure and subsequent licensure for broader category for it is a test that shall measure the competence of the examination takers.   Reference:   Credit:ivythesis.typepad.com

NURSING PRACTICE

Define clearly the advanced Practice Nurse. The advanced practice registered nurse is an umbrella term given to a registered nurse (RN)...

Assignment essay instructions on A research proposal on the sexuality-related nursing practice

Assignment essay instructions on A research proposal on the sexuality-related nursing practice

The overall comment from the assessor: Proposal presents non-experimental survey of sexuality-related nursing using established questionn...

Personal Application Paper on Nursing

Personal Application Paper Personal Application Paper on Nursing As a nursing practitioner, ethics or the ethics of nursing is another type of theory that describes about the moral obligations, moral and opposite values, and desires ends. The standards of practice, codes of ethics, and philosophies of nursing are the useful foundations of identification, analysis and clarification of beliefs and values. Personal or the interpersonal relationships of nursing is the type of nursing theory is concerned with the expressions of the quality and authenticity of the interpersonal process between each nurse and each patient. The gestures of communicating like opening for a story, thinking, listening, and reflecting can build a strong relation and trust between the patient and a nurse. Aesthetics or the art and act of nursing is the expressions of the nurse’s perceptions of what is significant in an individual patient’s behavior. The proper act should be done, specifically according to what the nurse had learned from the past and envisioning the possibilities for the possible outcomes. Personal knowing is meant by therapeutic nurse patient relationships which was developed by means of opening and centering the self to thinking about how one is or can be authentic, by listening to responses from others, and by reflecting on those thought and response. An application of nursing theory in practice depends on nurse having the knowledge and theoretical works as well as an understanding of how philosophies, models, and theories can relate to each other. The essence of nursing and its practice is the representation of the evolution of nursing as a profession and practice domain. The principles of the science of nursing, legal parameters, the definition of person, environment, health, and nursing are part of the essence of nursing practice. The technical skills and other useful knowledge can be a good foundation in pursuance of the nursing practice. The personal nursing theory comprises the framework of four paradigms that are all working together in nursing programs. The human beings are defined as individuals who are capable of conscious and organized thought who have inherent physiological and psychological needs. These individuals are not predefined but get defined in the course of living a life, where the mind, body, and spirit are integrated as one. The patient’s needs and problems must be evaluated in an individualized way but and considering the patient’s personal values and needs. The medical attendant must first weigh the attitude and behavior of a patient that can be applied in assessing the patient’s illness. Environment is the call for the human relationships. It is viewed through the representations of personal, social, national, and global dimensions, physical, psychosocial, cultural diversity, historical development, economic and political aspects are taken considerations. All the nurses and other medical practitioners create the path of these health attendants towards the career goal. The environment cannot stop that activity for the attitude towards the environment in the way to determine the essence of the activity that the medical team established.     Credit:ivythesis.typepad.com

Personal Application Paper on Nursing

Personal Application Paper Personal Application Paper on Nursing As a nursing practitioner, ethics or the ethics of nursing is another...

Health Promotion: WORKING THE WAY TO HEALTH INITIATIVES, The Natural Environment

WORKING THE WAY TO HEALTH INITIATIVES, The Natural Environment Introduction             Environmental issues generated a concern for the impact of environment on health (Bomar 2003, p. 535).  This is important because of the different health issues in the UK, particularly about inactiveness, which commonly result to obesity and lead to other chronic diseases such as cardiovascular diseases. As a matter of fact, over a fifth of adults in England are classified as obese, and this figure is rising between 1990 and 2000. While, the number of obese children is rising in all age group, and it is estimated that obesity accounts for around 30,000 deaths in England every year (Cornwall n.d.). Growing medical evidence showed that access to the natural environment help to improve health and wellbeing, at the same time, prevent disease and helps people to recover from illness. Thus, experiencing nature in the outdoors can help tackle obesity, coronary disease and mental health problems (Natural England n.d.).             Furthermore, environmental factor is considered as one of the most important health determinant because there are different studies which show that contact with the environment has healthy benefits. Aside from that, different issues about the environment, particularly pollution, have a great impact on the health of the people. The said factor is considered as one of the most important motivation of walking the way to health initiatives and the natural environment to focus on walking in order to motivate the people to become more physically active. What is Health Education?             The American Association for Health Education (AAHE) considered health education as a social science that draws from the biological, environmental, promote health and prevent disease, disability and premature death through education-driven voluntary behavior change activities. Thus, it is considered as a development of individual, group, institutional, community as well as systematic strategies in order to improve the health knowledge, attitudes, skills and behavior, with the main purpose to positively influence their health.             This is important because it help to improve the health status of individuals, families, communities, states as well as the nation, therefore enhances the quality of life for all people, at the same time, reduces the costs that individuals, employers, families, insurance companies, medical facilities, communities, the state and the nation would spend on medical treatment (AAHE n.d.). What is Health Determinant?             The European Centre for Health Policy (ECHP) (1999) defined health determinants as the personal, social, cultural, economic and environmental factors that influence the health status of individuals or population (cited in WHO 2009) Tackling the main health determinants is of great potential for reducing the burden of disease and promoting the health of the general population. Health determinants can be categorized as: personal behavior and lifestyle; influences within communities which can sustain or damage health; living and working conditions and access to health services; and general socio-economic, cultural and environmental conditions (European Commission n.d.). Health Education, Health Determinants and Walking the Way to Health and The Natural England Initiative             The Natural England is an independent public body whose purpose is to protect and improve England’s natural environment and encourage people to enjoy and get involved in their surroundings. The said organization works with people like farmers, town and country planners, researchers and scientists, and the general public on range of schemes and initiatives. The organization supports the Walking the way to Health to get sedentary people out on short local walks by supporting a network of more than 525 led walk groups across England. The organization offer support and advice, training for walk leaders, public liability insurance, an accreditation quality mark, evaluation and free materials in order to help promote walking (Natural England n.d.). The National Step-o-Meter Programme             The National Step-O-Meter Programme (NP) is being delivered by Natural England with partnership with the Department of Health which aims to promote and enables the effective use of pedometer via clinical practice. The aims of the said programme are: <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> 	To 	increase levels of walking in sedentary, hard to reach and ‘at risk’ groups;</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> 	to 	increase use of Step-O-Meters across the NHS as a motivational tool;</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> 	to 	increase awareness of the Chief Medical Officer’s recommendation that every 	adult should undertake at least 30 minutes of moderate activity on at least 	five days a week;</li> <li class="MsoNormal" style="text-align: justify; line-height: 200%"> 	to 	demonstrate how incremental increases in daily step counting through goal 	setting can be used as an effective and realistic introduction to physical 	activity (Natural England n.d.).</li> </ul> Based on the said aims and objectives, it can be said that WHI and Natural England, covers all of educational objectives. Primarily, cognitive because it enables to make sure that people fully comprehend the initiative by promoting abilities in thoughts, understanding and cognitive skills (Contento 2007, p. 525). On the other hand, affective because it enables the people to participate in the attitude-changing walking by promoting changes in attitude, feeling or emotion. Above all, psychomotor because the primary aims of WHI and Natural England is to promote healthy walking or to promote improvement in physical or manipulative skills (Contento 2007, p. 525). Because of the fact that walking is free and requires no special equipment or training, health professionals define walking as the nearest activity to perfect exercise (Morris & Hardman 1997 cited in Ramblers 2009). Furthermore, almost everyone is capable of walking, and everyone can almost walk anywhere, because it can be easily combined with walking for other reasons such as walking to work, school or shops visiting a place of interest and walking a dog (Ramblers 2009). Because of that, it can be said that the initiatives is targeting the normative need. Need refers to the relationship between the problems and the responses that are available (The Robert Gordon University n.d.). On the other hand, normative need pertains on the need which is identified according to a norm or set standard; such norms are generally set by expert (The Robert Gordon University n.d.). Experts are saying that, walking sociably with friends or in a group can help to improve mental health and quality of life. Aside from that, there are different evidences which show that by simply spending time in the outdoors and in contact with the natural environment has a positive effect on mental health (Pretty et al & Seymour 2003 cited in Ramblers 2009). Health Determinants and Social Inequalities             Socials and economic aspects have a great impact on implementation of any health promotion. Inequalities are considered as an important factor in health promotion, particularly with the issue of economic status or condition. In that case, WHI, and the partner organization, enables to remove the negative impact of social inequalities by pushing walking as a primary exercise or solution to physical inactiveness. This is because of the fact that unlike most other forms of exercise, walking is free and requires no special equipment or training, it is safe and low-impact with a low risk of injuries and accidents, people can enjoy different surroundings a they walk in different places and different seasons, above all, people don’t need to concentrate on the walking itself, leaving them free to enjoy the surroundings, at the same time, improve the social well-beings by chatting to companions or just relax (Ramblers 2009).             As a result, because there’s no need to spend extravagant amount of money and effort, people, regardless of their social and economic status or condition can cooperate or join the initiatives. This is because of the fact that being physically inactiveness is connected to social and economic condition because those people with lower income and living in rural areas have a minimum access to different facilities that can help them to become physically active. This is also connected to the issue of diet, where in those minority group is experiencing obesity and overweight, because they are lacking from financial and information support regarding healthy eating and healthy lifestyles. The Beattie Model             Health promotion represents mediation between people and their environment. Therefore, the role and actions of health promotion involves looking at the total environment, which enhances health. Thus, health promotion activities not only include improvement in food, income, housing and building of skills but also on the process of creating supportive environments which result in personal and community empowerment (Dines & Cribb 1993 cited in Thomas & Stewart 2003). The said factor can be achieved via education; legislation as well as community based social actions. In connection, Beattie (1991), offer an analytical model, which enables us to critically analyze the different approaches that are used by successive governments. The Beattie model has four quadrants, each quadrant express the means by which professional may promote health. Significantly, each quadrant is infused with its own philosophies, beliefs and values and outcome measurements with connection to health promotion. Thus, the approaches can be directed at an individual or at population level (cited in Thomas & Stewart 2003).             WHI occupies the quadrant D of Beattie’s model of health promotion or the community development. It focuses on empowering or enhancing the skills of a group or local community (Naidoo & Wills 2000, p. 106). Thus, it is characterized by groups of people who have the same health concerns or similar circumstances coming together in order to take action in order to improve health prospects (Blackie & Appleby 1998, p. 185). Therefore, it can be said that WHI serve as an advocate of walking for those people from majority and minority groups. Thus, create a collaborative approach in order to remove any risks that are connected with physical inactivity and focus on walking as the community development action.  The main advantage of quadrant D is that it enables the people to work together and participate in the activity, as a result, the initiative will be more attractive to the people, because it’s a social activity, which given them the chance to work together and fight health problems. Therefore, working together to achieve healthy lifestyles, will serve as a motivation for those people to overcome different barriers that are connected to physical activeness. On the other hand, the main disadvantage is that the campaign will primarily tackle on the needs of the people as a group, setting aside those individual factors that are also important in promoting health. Furthermore, it will use the radical political ideology, that is directly connected to the results from different ideas and studies of different individuals and groups about walking and its impact on healthy lifestyle, therefore, it will assume that all of the people are capable of walking, overlooking the fact about other important aspects that are connected to health such as disabilities. Ethical Assessment             Like what have mentioned in the first part of the paper, health promotion focus on working in order to develop health or the people, therefore, it is important to consider the fact that in order to come up with any initiative that is connected to health promotion, it is important to take note that different decisions and plan to be implemented will affect the lives of each individual who belong to the target of a specific program. In that case, it is important to focus on the different ethical issues that are related to the WHI. Ethics is considered as a philosophical discipline that focused on moral values, with differentiation between what is considered to be right and wrong (Jonas & Lawrence 1996, p. 554).             Because of the fact that the initiative use community development, it is important to consider the basic principles of biomedical ethics, primarily the issue of respect for persons by autonomy or recognizing free will and human rights, dignity and freedom (Jonas & Lawrence 1996, p. 555). Because WHI is integrated on the setting of community, it is vital the health development will be both people and communal-centric, which mean that it must thrive that all of the members of the community will have the access to the health initiative. In that case, autonomy is considered as the main advantage of the initiative, because it enables the people to have a voluntary action regarding joining the activity or program. Therefore, it leaves no distinct group or subgroup to be abandoned, as well as the fact that the activity can be done during free time for the walker because it only requires 30 minutes. As a result, it makes the walker to be comfortable and relax, at the same time, give him or her more energy, lessen stress, help them to have healthy sleep, maintain strong heart and lessen abnormal blood pressure and help them to manage weight. On the other hand, the said initiative will have a problem regarding beneficence or the principle of doing good (Jonas & Lawrence 1996, p. 555). This is because of the process that is needed in order to know if a person is capable to walk or need some support. Therefore, it will need medical examinations that will result to additional cost. However, this will not affect the activity because it will be supported by the government and other important organization. Evaluating Health Activity             As of now, the initiative had been able to show success in the implementation of activities that are related to physical activeness of people. There is more than 90% of Primary Care Trust in England that are involved in the project, with more than 9,000 loan pack distributed which is equivalent to total of 90,000 Step-O-Meters. It had been able to train more than 8,000 frontline health professionals and about 200 cascade trainers.             This has been done because of effective evaluation which is considered as an important aspect in health promotion. This is because it helps to focus on the concepts of efficiency and cost-effectiveness that is subject to the development of new initiatives (Thorogood & Coombes 2004, p. 28). The initiative is being evaluated by Outdoor Health Questionnaire which focuses on the development of the programs that are being implemented. The data are collected individually by using a standard at levels of local, regional and national. The questionnaire is consists of information including the screening data, demographic data including contact information, age, range, gender as well as ethic group. As supporting information, supplementary information was also asked about their performance on physical activeness. Thus, it can be observe that the said evaluation method is effective in knowing him outcome of the initiative because it enables to analyze the different changes in terms of level of physical. Even though, this activity may not instantly show the changes in terms of physical activities, it can show the different changes in terms of behaviors regarding the health walking and inactiveness in physical terms in the long run. On the other hand, the main disadvantage is that the evaluation is focusing on self-evaluation, thus the data gathered cannot be considered as 100% reliable, because respondents might overrate themselves. Conclusion             Based on the different information gathered, it can be said that the initiatives towards health walking is a successful health promotion. This is because, primarily, it enables people to be more aware regarding the negative impact of physical inactiveness, and the positive impact of walking. Furthermore, it also helps to remove any inequalities because walking can be done and applied by most population in everyday life, without any hassles. This is because is already a part of our daily habit. On the other hand, the main disadvantage is that it tend to generalize the population, therefore individual needs will not be catered, primarily the issue of physical and intellectual disabilities.   References AAHE, What is Health Education, American Association for Health Education, viewed 27 April 2009, <http://www.aahperd.org/aahe/template.cfm?template=publicatio ns-jobs.html> Blackie, C & Appleby, F 1998, Community Health Care Nursing, Elsevier Health Sciences Bomar, P 2003, Promoting Health in Families: Applying Family Research and Theory to Nursing Practice, Elsevier Health Sciences Contento, I 2007, Nutrition Education: Linking Research, Theory and Practice, Jones & Bartlett Publishers Cornwall, The Health and Well Being Strategy for Cornwall and Isles of Scilly, viewed 27 April 2009, <http://www.cornwallandislesofscilly.nhs.uk/CornwallAndIsles OfScillyPCT/StayingHealthy/HealthAndWellbeing/WellbeingFiles/StrategyCornwall/AccessToLeisureAndRecreation.pdf > European Commission, Health Determinants, viewed 27 April 2009, < http://ec.europa.eu/health/ph_determinants/healthdeterminants_en.htm> Jonas, S & Lawrence, R 1996, Health Promotion and Disease Prevention in Clinical Practice, Lippincott Williams & Wilkins Naidoo, J & Wills, J 2000, Health Promotion: Foundation for Practice, Elsevier Health Sciences Natural England, Health and Natural Environment, viewed 27 April 2009, < http://www.naturalengland.org.uk/ourwork/enjoying/health/default.aspx > Ramblers 2009, Walking Is the Nearest Activity to Perfect Exercise, viewed 27 April 2009, < http://www.ramblers.org.uk/info/factsandfigures/health.htm> The Robert Gordon University, An Introduction to Social Policy, viewed 27 April 2009, < http://www2.rgu.ac.uk/publicpolicy/introduction/needf.htm> Thomas, S & Stewart, J 2003, ‘Optimizing Health Promotion Activities’, JCN Online, vol. 19, no. 1, viewed 27 April 2009, <http://www.jcn.co.uk/journal.as p?MonthNum=01&YearNum=2005&Type=backissue&ArticleID=750> Thorogood, M & Coombes, Y 2004, Evaluating Health Promotion: Practice and Methods, Oxford University Press WHO 2009, Glossary of Humanitarian Terms, World Health Organization, viewed 27 April 2009, < http://www.who.int/hac/about/definitions/en/index.html>   Credit:ivythesis.typepad.com

Health Promotion: WORKING THE WAY TO HEALTH INITIATIVES, The Natural Environment

WORKING THE WAY TO HEALTH INITIATIVES, The Natural Environment Introduction Environmental issues generated a concern for t...

ADN Nursing Synthesis Paper

ADN Nursing Synthesis Paper A.          Describe at least one example of how you functioned within each of the BSN roles during your clinical time: 1.    Member Within the Discipline As a nurse, it is important to know how I will be more functional to perform my duties and responsibilities during the clinical time. This part will discuss some example of how I function within each BSN roles during my duties. The role started on caring five patients with different illnesses the first shift. It can be said that on all duties, I handled an average of five clients. As a member of discipline, I can say that I have functioned very well on each of the six shifts at Medical Surgical Floor. First, I did my usual routine of checking the client’s wellness and their vital signs and provide their needs. For each of the patient’s I tried to know information about them, their clinical background and the medicines that they are taking. In addition, as a member of discipline, my role is to coordinate with other members for the sake of the patients. For instance, I coordinate with ICU nurse to ensure that all information needed for surgery of patient that will undergo VATS are received properly to ensure safety and correct care. During these hours, perform my duty in checking the condition of the patients from time to time.   2.     Provider of Care For each of the shift, I can say that it is also my responsibility to provide proper care on each of the patient that I handle during those shifts.  My first role is to check the patient’s condition and record and documents it as a standard procedure. For instance, during the first shift with five patients, I see to it that as a provider of care I always visit and assess the clients. In addition, I also tend to attend to their immediate needs and consider follow-up if the patients still need something about his/her medication and other related aspects.  As a provider of care, my role is to ensure that all the needs of the patients are being provided.   In addition, I also give positive outlook for patients and talking to them to motivate them and help them have a positive behavior like what I have done with the patient in the ICU during the fifth shift.   3.     Manager of Care As manager of care, it is my duty and responsibility to have enough knowledge and the ability to manage resources efficiently, be flexible as well as adaptable to different changes and cooperate or collaborate with other healthcare providers. In addition, it is also my duty to apply quality improvement measures, show advocacy and respect for clients and members of the healthcare team. Moreover, it is also my role to seek assistance if I need it to provide quality care. During my shifts, I also observed my being a manager of care when I collaborate with the Doctors and nurses to provide the needs of the patients. For instance, during my third shift in the Medical surgical floor, I have see to it that the client has been administered with the antibiotics before he went to have a CT scan.  I can say that as a manager of care, I am able to show my flexibility in providing efficient care with each of the patient from the first shift to the last shift on the medical surgical floor.   B.           Analyze your attainment of ADN program outcomes through a brief evaluation of each of your individualized clinical objectives. Provide specific examples of how each objective was met. As an ADN, I have many duties and responsibilities to fulfill and I am entitled to attain my individualized clinical objectives. For each of the shift, I am able to encounter different patients which challenged my abilities and skills and also help me to learn more about my career. As an ADN, I am bound to various clinical objectives which is shown below and the evaluation on how I achieve it during the shifts I made in the Medical surgical floor.   		 		 		Objectives 		 		 		Ways on attaining Objectives 		 		Providing and managing the care of clients <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal"> 			 			I did it by using the nursing process and supported by evidence- 			based practice which results in safe and competent client care. 			 </li> <li class="MsoNormal"> 			 			I also did it by incorporating caring interventions into all aspects 			of client care for each of the client in the shift. </li> </ul> 		 		Ensuring Client’s safety and holistic care <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal"> 			 			I did it by demonstrating critical thinking and problem solving 			skills in the management and delegation of client care for each of 			the shift at medical surgical floor. </li> <li class="MsoNormal"> 			 			I did it by considering the integration of ethical and legal 			concepts in providing client care </li> <li class="MsoNormal"> 			 			Employing therapeutic communication skills with clients and other 			healthcare team members while effectively utilizing various forms of 			proper resources in the healthcare setting. </li> </ul> 		 		Ensuring Personal Growth and Commitment <ul style="margin-top: 0in; margin-bottom: 0in" type="disc"> <li class="MsoNormal"> 			 			I did it by being a keen observer during my duties, specifically in 			times when other healthcare providers are in challenging situation 			and I tried to learn from what they are doing. </li> <li class="MsoNormal"> 			 			Collaborate with peers and other members of a multidisciplinary 			health care team to coordinate quality client care. </li> <li class="MsoNormal"> 			 			Provide culturally sensitive care to a diverse population like what 			I did during my duties in which I have to provide care for five 			patients with different illnesses and medical needs. </li> </ul>   C.          Analyze your perceptions of each of the Department of Nursing’s conceptual framework threads 1.       Professional NURSING Based on what I have observed during my shifts and duties in Medical Surgical floor, I can say that professional nursing means provision of holistic care for other people as well as the utilization of various complementary healing modalities. I perceived that professional nurse are the once who provide care. In addition, professional nurse are those individuals who can provide holistic care in any given situation. 2.        HEALTH Based on what I have observed during my duties and clinical time, I perceived health as a condition of an individual in the absence of diseases. In addition, I can say that health can be perceived as the balance of physical, emotional, social, spiritual, and intellectual condition of an individual.  I believed that being healthy means that a person not have any disease or chronic illnesses and have an improved well-being and self-sufficiency to do every physical and mental activities normally. 3. Environment Based on what I have observed in my duties, I perceived environment, specifically healthcare environment as place where holistic care for patients are being provided at all cost. In addition, I also perceived environment wherein you can fulfill your duties and obligations for the benefit of the clients or patients. 4. HUMANITY             In the aspect of nursing, I perceived humanity as embracing more than a benevolent technically competent subject-object one-way relationship which is guided by a nurse on behalf of another. In addition, I also perceived humanity as a form of nursing which means that nursing is a responsible searching, transactional relationship whose meaningfulness demands conceptualization founded on a nurse’s existential awareness of self and the other. Nursing is an experience lived between human beings. All therapeutic action initiated by the nurse in the care of another human being occurs through a self in action, but this is not necessarily through the therapeutic use of self or the art of nursing. D.Discuss your definition, use of, and growth in critical thinking through this course/program Critical thinking in this course/program means, having the ability to determine the most appropriate actions for the sake of the patient or the client.  In addition, it can be said that critical thinking in this course is very important so as to provide proper and holistic care to specific patients.  As I have mentioned, nurses should learn various skills constantly, considering that this field undergoes continuous transitions and developments. Professional nurses should partake in various activities and trainings that will enhance not only their knowledge and skill but also their competence as care providers. My decision to take up the course on ADN would be one of the many steps that I need to take to further develop my skills of emergency nursing practice required to deliver high quality, non-discriminatory practice in order to promote their health and well-being. E.Discuss your professional development this semester and how this course has provided synthesis. Nursing is a unique profession, particularly in terms of their role as health care providers. Aside from the needed technical skills that will facilitate proper patient care, nurses must also have the appropriate attitude and outlook to help both sick and well individuals. Patient care is a vital aspect of nursing and the fundamental role of nurses (Rafael, 1996). The provision of sufficient attention to the comfort as well as the promotion of health and treatment of patients is also part of the nurses’ role. The experiences that I have in this semester has enable me to identify various patient needs and deliver appropriate care. In addition, as part of my professional development, I am able to develop inherent characteristics which I believe can positively help me become an efficient nurse. Through this, I am able to have a strong sense of judgment. I can react and think quickly when situations occur. Moreover, I can easily address a situation based on knowledge as well as my past experiences. I think with these experiences in this semester, I can fulfill the role of a nurse with strong conceptualization skills. Aside from this, I can also become an efficient nurse who is willing to share my knowledge and experience to others. I can say that the activities I have done contributed to the realization of my role as a professional nurse. I believe that it is not enough to do research and consult other experts about this matter. A plan should be developed in our nursing unit, identifying specific ways on how to integrate effective communication practices. However, my consultation with a superior nurse has helped me realized the importance of interacting with the patients and their family members, particularly in understanding their situation as well as their feelings and thoughts. Much research must be conducted for this objective, particularly in sample case studies. This I believe will give me an idea on how to develop a possible plan for effective communication.   D.          Summary and Conclusion: Discuss your nursing career goals and the hopes you. Have for nursing in the future. Based on this analysis and the experiences I had for this semester, I can say that my nursing career goals is to pursue my nursing career and take on a higher level of nursing to provide holistic and quality care for my patients. I will continue to gain experiences to enhance my knowledge and I will not stick into non-actual knowledge so that I may be able to efficiently use what I have practiced on actual situations. My plan is to continue the course and learn more about it and also about nursing.  I believe my professional knowledge would be updated through specialized training. Specifically, I can improve my patient care abilities by working with the latest medical technology as well as with other highly trained medical personnel. These can provide significant inputs which I can use in my profession. In today’s contemporary world, nurses must have the necessary skills and training in various areas that will help them comply with the modern and scientific health research approach. In addition, these trainings can equip them with the knowledge on how to enhance the quality of patient care and apply technical skills for effective health care management. As stated by a number of authors, nurses must have the skills and abilities that will enable them to practice lawful, safe and effective patient care. These skills would have to be obtained through sufficient education and training. As nursing is a dynamic profession, my professional skills and knowledge as a nurse must be continuously updated. Through training and constant education, I will be able to discover new techniques on patient care as well as find other means on how to enhance my strengths and overcome my weaknesses as a professional nurse. In addition, training and education will also help me develop other significant skills including flexibility, self-confidence and adaptability, which in turn can help me grown professionally and personally.   Credit:ivythesis.typepad.com

ADN Nursing Synthesis Paper

ADN Nursing Synthesis Paper A. Describe at least one example of how you functioned within each of the BSN roles during your c...

Paper on Advance Nursing Practice (ANP) and its Characteristics

PAPER ON ADVANCE NURSING PRACTICE Increased emphasis on primary health care, new models of collaborative practice, the shift from institutional to community care, new developments in technology, and the supply and demand for various health providers with particular skills. These are the new trends in the delivery of health care that give opportunities for the expansion and creation of new roles for nurses. To better meet the changing needs of health care of patients in our modern times, the practice of nursing must continue to develop. One possible career path nurses may opt to trail is the advance nursing practice, or ANP, where nurses [registered nurses] learn additional competencies integrated in their practice as they move along the move along the field of experience and education This enables nurses to contribute to the health care system in new ways. (Canadian Nurses Association, 2002, p. 2) What is Advance Nursing Practice (ANP) and its characteristics? According to the Canadian Nurses Association [CNA] (2002), advance nursing practice (ANP) is an umbrella term that describes an advanced level of nursing practice that maximizes the use of in-depth nursing knowledge and skill in meeting the health needs of clients (individuals, families, groups, populations, or entire communities). In this way, ANP extends the boundaries of nursing’s scope of practice and contributes to nursing knowledge and the development and advancement of the profession. (p. 4)             CNA further explains: ANP is an expert and specialized practice grounded in knowledge that comes from nursing theory and other theoretical foundations, experience and research. It involves the deliberate, purposeful and integrated use of in-depth nursing knowledge, research and clinical expertise. It also involves integration of knowledge from other disciplines into the practice of nursing. ANP requires a depth and breadth of knowledge that enables the nurse to provide an ever-increasing range of strategies to meet the complex needs of clients. Also, ANP may, but does not necessarily, include activities that have been traditionally considered outside the scope of nursing practice. (CNA, 2002, p. 4-5)   Who are the Advance Practice Nurses (APNs)?             Advanced Practice Nurse (APN) is an umbrella term that is given to a registered nurse (RN) who has met advanced educational and clinical practice requirements beyond the 2 4 years of basic nursing education required of all RNs. There are four principal types of APNs: the Nurse Practitioner (NP), Certified Nurse Midwife (CNM), Clinical Nurse Specialist (CNS), and Certified Registered Nurses Anesthetist (CRNA). (American Nurses Association, 1997) ISSUES ON APN:             Harris (1998) made a research on the role of APNs in meeting the health care needs of the 21st century patients. The research basically discussed the issue of APNs acceptance as a viable health care provider. Harris found out that that there are certain factors that favor for the broadening of APNs scope of responsibility for primary care, which include: the pressing need to contain US’ continuing increase in health care costs, the window of opportunity for advanced nursing practice (or the transformation of health care in the US), and the need to use fewer resources more effectively. Harris discussed: “Because ours is a market-driven health care system with a growing surplus of physicians, NPs increasingly find themselves in direct competition with physicians for the same primary care jobs. Hence, market-driven (rather than identical) pricing of services is necessary if NPs are to compete successfully with medically trained providers of primary care.” (Harris, 1998)             Therefore, APNs need to widen their scope of practice to better meet the needs of their possible clients. As the Pew Health Professions Commission (1995), suggested: “Advanced preparation…will permit the nursing professional to develop the information background and experience base to operate more independently, work in community settings, more effectively manage the health of patients and make an even more profound contribution to health care…. In many ways nurses are the best prepared professionals to respond to the changing system. Their training focuses on the delivery of cost effective care;…they combine clinical and managerial skills; they focus on the behavioral aspect of health more than physicians; and they are effective team workers and leaders.” (p. 49) (Note: Advanced Nursing Practice (ANP) and Advanced Practice Nursing (APN) are used interchangeably in this paper.)   References: American Nurses Association. (1997). Advanced Practice Nursing: A New Age in     Health             Care. In Nursing World. Available at:      [www.nursingworld.org/readroom/fsadvprc.htm]   Canadian Nurses Association. (2002). Advanced Nursing Practice: A National   Framework.   Ottawa: Author   Harris, Ruth M. (1998). Advanced Nursing Practice in the 21st Century: Do We           Want to Be             Right, or Do We Want To Win?. In Online Journal Issues of             Nursing. Available at: [www.nursingworld.org/ojin/tpc6/tpc6_2.htm ] Pew Health Professions Commission.(1995). Critical challenges: Revitalizing the                     healthcare professions for the twenty-first century. San Francisco, CA:   University     of California, San Francisco Center for the Health Professions. Credit:ivythesis.typepad.com

Paper on Advance Nursing Practice (ANP) and its Characteristics

PAPER ON ADVANCE NURSING PRACTICE Increased emphasis on primary health care, new models of collaborative practice, the shift f...